17to85 Posted June 25, 2019 Report Posted June 25, 2019 Is a lot of the anguish about healthcare the closing of emergency rooms at some hospitals and consolidating them at the bigger centers? Help me understand as someone who hasn't followed it super closely.
Wanna-B-Fanboy Posted June 25, 2019 Report Posted June 25, 2019 1 hour ago, FrostyWinnipeg said: https://business.financialpost.com/pmn/business-pmn/china-to-stop-all-imports-of-meat-products-from-canada-on-wednesday-media-report China bad mmmmkay? Oh nice... more retaliatory trade shenanigans
rebusrankin Posted June 25, 2019 Report Posted June 25, 2019 20 minutes ago, 17to85 said: Is a lot of the anguish about healthcare the closing of emergency rooms at some hospitals and consolidating them at the bigger centers? Help me understand as someone who hasn't followed it super closely. In part that + Nurses and Doctors complaining about unrealistic workloads and stress + Long Waiting Times + Incidents like St B's Emerg sending people away + Likely forgetting things
17to85 Posted June 25, 2019 Report Posted June 25, 2019 I can see the merit in turning some emergency rooms into urgent care though. A lot of emergency visits can be handled by urgent care and perhaps it helps bolster emergency room resources at the remaining locations. I don't think there is a healthcare worker anywhere who doesn't feel stressed or overworked.
kelownabomberfan Posted June 25, 2019 Report Posted June 25, 2019 Unfortunately been to the emergency here in Kelowna too many times (never for myself, just family members) - almost without fail it is clogged with elderly folk needing some sort of long-term care but unable to find it, and drug addicts crashing. Is there another place to funnel these people other than emergency?
FrostyWinnipeg Posted June 26, 2019 Report Posted June 26, 2019 1 hour ago, wanna-b-fanboy said: Oh nice... more retaliatory trade shenanigans Maybe not, looks like we started it by alerting them to some suspect beef. https://www.cbc.ca/news/politics/china-ban-canadian-meat-1.5189874
bigg jay Posted June 26, 2019 Report Posted June 26, 2019 35 minutes ago, 17to85 said: I can see the merit in turning some emergency rooms into urgent care though. A lot of emergency visits can be handled by urgent care and perhaps it helps bolster emergency room resources at the remaining locations. I don't think there is a healthcare worker anywhere who doesn't feel stressed or overworked. As I said in my last post, it's not so much what they are doing but how they are doing it. One of the biggest problems has been that they haven't adequately increased the resources (staff, beds, etc) at the existing ER's to match the increased patient levels. The remaining ER's are already overwhelmed and now they are getting ready to close another one before fixing the problems that currently exist. Wideleft 1
nate007 Posted June 26, 2019 Report Posted June 26, 2019 Politicians who try to implement changes like this are in a tough spot. It's not them doing the work, and 95% of them have no experience with anything like this, but they're going to get all the blame. Right now they're relying on the folks over at the WRHA to pull this off (Dr. Brock Wright ring a bell? he's been near the top there since long before this government came in), and of course there will be bumps in the road. Gotta give them credit for at least trying though...
Wanna-B-Fanboy Posted June 26, 2019 Report Posted June 26, 2019 (edited) 1 hour ago, FrostyWinnipeg said: Maybe not, looks like we started it by alerting them to some suspect beef. https://www.cbc.ca/news/politics/china-ban-canadian-meat-1.5189874 I stand corrected- I thought it was the same "issues" china had with canola shipments from Canada. Edited June 26, 2019 by wanna-b-fanboy
Wanna-B-Fanboy Posted June 26, 2019 Report Posted June 26, 2019 53 minutes ago, nate007 said: Politicians who try to implement changes like this are in a tough spot. It's not them doing the work, and 95% of them have no experience with anything like this, but they're going to get all the blame. Right now they're relying on the folks over at the WRHA to pull this off (Dr. Brock Wright ring a bell? he's been near the top there since long before this government came in), and of course there will be bumps in the road. Gotta give them credit for at least trying though... This is being driven ideologically- it was poorly planned, poorly executed and there are still a tremendous amount of problems yet they double down and push it through... It is people's health and lives, perhaps see what needs to be changed and ADD SOME RESOURCES. https://www.winnipegfreepress.com/local/wrhas-chief-medical-officer-fall-guy-for-blundered-er-consolidation-expert-says-511263552.html Quote Levy said it's apparent that the provincial government has moved too quickly in instituting the changes. From an outsider's perspective, it also appears that the system overhaul has been a top-down process. "It's 1950s management. 'You're going to do what we tell you to do and be happy you have a job.' That's nonsense. The world doesn't work like that anymore," he said. https://www.cbc.ca/news/canada/manitoba/st-boniface-doctor-er-1.5177392 People being turned away from StBER? when has a hospital turned people away? Quote "If you talk to most of the physicians who deliver in-hospital care, they feel they are under-resourced as far as beds and services," he said. "It adds to a difficult work environment, when you're continually juggling beds, and juggling patients, and you don't have space available." Doucet said he's concerned the transformation of Concordia's emergency room into an urgent care centre earlier this month may have played into the high number of patients at his hospital "I think with the decreasing capacity in the system, it's more likely to happen more often," he said. "I'm very concerned." Gotta give them credit for trying? They took a non-ideal situation and ****** it up beyond anything acceptable and people are dying because of it. yeah. good on them for trying... ******* incompetent, ideologically driven forays into people's health care and endangering the lives of people seeking care... sure... that's the credit they deserve. Bravo Premier Lurch. Bravo. Wideleft 1
bigg jay Posted June 26, 2019 Report Posted June 26, 2019 1 hour ago, nate007 said: Politicians who try to implement changes like this are in a tough spot. It's not them doing the work, and 95% of them have no experience with anything like this, but they're going to get all the blame. Right now they're relying on the folks over at the WRHA to pull this off (Dr. Brock Wright ring a bell? he's been near the top there since long before this government came in), and of course there will be bumps in the road. Gotta give them credit for at least trying though... The flipside to that is that there are other changes that could be made but the government will not touch because of the political cost. Changes to the Home Care program for example, could save taxpayers a ton but it's non-starter for the PC's. The last figures I saw, had Manitoba providing 5x the national average in hours of home care per week. We also provide services that no other province allows (like housekeeping and laundry) when we definitely cannot afford to.
Wideleft Posted June 26, 2019 Report Posted June 26, 2019 (edited) 13 hours ago, nate007 said: Politicians who try to implement changes like this are in a tough spot. It's not them doing the work, and 95% of them have no experience with anything like this, but they're going to get all the blame. Right now they're relying on the folks over at the WRHA to pull this off (Dr. Brock Wright ring a bell? he's been near the top there since long before this government came in), and of course there will be bumps in the road. Gotta give them credit for at least trying though... Trying without a plan is dangerous when it comes to health care. Don't forget that all health authorities were mandated to slash 15% of managers and 3% of costs regardless of their balance sheets before the transformation even began. Any government with any interest in actual outcomes would not dictate the same austerity measures to each region when some were actually meeting their budgets. Why would you eliminate the very people who have experience and knowledge of the system before you start planning transformation? A patient dying in an ER after waiting 6 hours is much more than a bump in the road, but that's the kind of lack of compassion that this government is banking on with voters. Edited June 26, 2019 by Wideleft Wanna-B-Fanboy 1
nate007 Posted June 26, 2019 Report Posted June 26, 2019 You're right, bumps in the road was underselling it. However, I'd prefer that they try something over just kicking the can down the road with the status quo that will never get better. The Vic transition to urgent care seems to have gone better than the Concordia and 7 Oaks (maybe folks in those areas are just making more noise?). That one seems to have had a more definitive plan and time frame. I still think that a good way to drive down wait times would be to re-direct people who have no business being at an ER (or Urgent care) in the first place. Set up a 24-hour walk-in beside each one and have the triage nurse tell them they can either wait 12 hours at the ER, or much less at the walk-in. They can't turn people with the sniffles away, but they could realistically present them with their options...
Wideleft Posted June 26, 2019 Report Posted June 26, 2019 10 minutes ago, nate007 said: You're right, bumps in the road was underselling it. However, I'd prefer that they try something over just kicking the can down the road with the status quo that will never get better. The Vic transition to urgent care seems to have gone better than the Concordia and 7 Oaks (maybe folks in those areas are just making more noise?). That one seems to have had a more definitive plan and time frame. I still think that a good way to drive down wait times would be to re-direct people who have no business being at an ER (or Urgent care) in the first place. Set up a 24-hour walk-in beside each one and have the triage nurse tell them they can either wait 12 hours at the ER, or much less at the walk-in. They can't turn people with the sniffles away, but they could realistically present them with their options... Can't argue with you there, but it begs the question, "Then why did this government essentially force the closure of 4 of 5 Quick Care Clinics?" https://www.cbc.ca/news/canada/manitoba/quick-care-clinics-closing-1.4199537 Wanna-B-Fanboy 1
Fatty Liver Posted June 26, 2019 Report Posted June 26, 2019 (edited) 1 hour ago, nate007 said: You're right, bumps in the road was underselling it. However, I'd prefer that they try something over just kicking the can down the road with the status quo that will never get better. The Vic transition to urgent care seems to have gone better than the Concordia and 7 Oaks (maybe folks in those areas are just making more noise?). That one seems to have had a more definitive plan and time frame. I still think that a good way to drive down wait times would be to re-direct people who have no business being at an ER (or Urgent care) in the first place. Set up a 24-hour walk-in beside each one and have the triage nurse tell them they can either wait 12 hours at the ER, or much less at the walk-in. They can't turn people with the sniffles away, but they could realistically present them with their options... Wrong, they can and they need to turn them away or they will return time and time again with minor ailments. It's a small percentage of the population that abuse the health-care system and often they are oblivious to the cost or the concept that they're doing anything wrong. Edited June 26, 2019 by Throw Long Bannatyne JCon 1
JCon Posted June 26, 2019 Report Posted June 26, 2019 19 minutes ago, Throw Long Bannatyne said: Wrong, they can and they need to turn them away or they will return time and time again with minor ailments. It's a small percentage of the population that abuse the health-care system and often they are oblivious to the cost or the concept that they're doing anything wrong. And, they're the ones that complain about lengthy wait-times.
17to85 Posted June 26, 2019 Report Posted June 26, 2019 You can't turn people away because what if it is a more serious underlying condition? What people need to do though is not use an er for things a doctors appointment can handle. JCon 1
nate007 Posted June 26, 2019 Report Posted June 26, 2019 2 hours ago, Wideleft said: Can't argue with you there, but it begs the question, "Then why did this government essentially force the closure of 4 of 5 Quick Care Clinics?" https://www.cbc.ca/news/canada/manitoba/quick-care-clinics-closing-1.4199537 Quick Care Clinics (at least the ones I'm aware of) had a lot of flaws that did not make them good for what I was describing. They weren't adjacent to hospitals, they had limited hours (like, worse than banks), and (at least when I went) you were encouraged to call ahead and make an appointment and were discouraged from walking in. They were very nice and modern inside though, so it wasn't surprising to see them snapped up by doctors when the leases were cancelled. The nurse practitioner model was also great, and needs to be expanded exponentially.
Wanna-B-Fanboy Posted June 26, 2019 Report Posted June 26, 2019 Well, this has been going on for awhile... have they fixed the ambulance problem? https://globalnews.ca/news/3945798/health-officials-downplay-row-of-ambulances-outside-winnipeg-hospital/
Wideleft Posted June 26, 2019 Report Posted June 26, 2019 19 hours ago, 17to85 said: Is a lot of the anguish about healthcare the closing of emergency rooms at some hospitals and consolidating them at the bigger centers? Help me understand as someone who hasn't followed it super closely. It's more nuanced than the closure of ER's, but that's been the main takeaway in the media. The execution of the transformation has been putrid. As already mentioned, a symbolic chopping of staff and budgets took place prior to the transformation office formation across all health regions regardless of budget performance. Positions were eliminated across ER's and urgent care centres forcing staff to reapply, retire or flee to other facilities/organizations. This left many facilities short-staffed, forcing double-shifts and overtime which is not saving anyone money and exhausts front-line workers which adds risk to patient care. The Province decided to leave the second biggest hospital out of transformation for a reason that has yet to be explained. How can you properly transform health care services provincially and let the second biggest hospital do it's own thing? Closing Concordia's ER leaves a big chunk of East Winnipeg and the Eastern bedroom communities without ready access to emergency care (Winnipeg has no freeways). In my opinion, the Grace (West Winnipeg) was only left open because their $44 million dollar ER upgrade was well under way before the PC's got to power. They put a PR person in charge of the Health Transformation Office. They shut down 4 of 5 Quick Care Clinics in Winnipeg prior to Transformation. They put a stop to all plans for new long term care facilities and created unreasonable $/bed requirements for new approvals. Manitoba was the last province to come to an agreement with the Feds on additional health funding. An ideal plan should (at least): offer more non-emergency options Quick Care Clinics closed, Misericordia Hospital urgent care closed make changes where needed and keep what's working Staff and budgets cut equally across regions regardless of Health Region's performance Allow all health regions and facilities to work together towards common goals and best practises St. Boniface Hospital left out Increase long term care beds to clear beds in Acute Care and Urgent Care facilities Pallister reneged on election promise to add 1200 long term care beds. Allow facilities and health regions the opportunity and time to properly transition staff and services Been covered - they didn't. Wanna-B-Fanboy 1
Wanna-B-Fanboy Posted June 26, 2019 Report Posted June 26, 2019 2 minutes ago, Wideleft said: It's more nuanced than the closure of ER's, but that's been the main takeaway in the media. The execution of the transformation has been putrid. As already mentioned, a symbolic chopping of staff and budgets took place prior to the transformation office formation across all health regions regardless of budget performance. Positions were eliminated across ER's and urgent care centres forcing staff to reapply, retire or flee to other facilities/organizations. This left many facilities short-staffed, forcing double-shifts and overtime which is not saving anyone money and exhausts front-line workers which adds risk to patient care. The Province decided to leave the second biggest hospital out of transformation for a reason that has yet to be explained. How can you properly transform health care services provincially and let the second biggest hospital do it's own thing? Closing Concordia's ER leaves a big chunk of East Winnipeg and the Eastern bedroom communities without ready access to emergency care (Winnipeg has no freeways). In my opinion, the Grace (West Winnipeg) was only left open because their $44 million dollar ER upgrade was well under way before the PC's got to power. They put a PR person in charge of the Health Transformation Office. They shut down 4 of 5 Quick Care Clinics in Winnipeg prior to Transformation. They put a stop to all plans for new long term care facilities and created unreasonable $/bed requirements for new approvals. Manitoba was the last province to come to an agreement with the Feds on additional health funding. An ideal plan should (at least): offer more non-emergency options Quick Care Clinics closed, Misericordia Hospital urgent care closed make changes where needed and keep what's working Staff and budgets cut equally across regions regardless of Health Region's performance Allow all health regions and facilities to work together towards common goals and best practises St. Boniface Hospital left out Increase long term care beds to clear beds in Acute Care and Urgent Care facilities Pallister reneged on election promise to add 1200 long term care beds. Allow facilities and health regions the opportunity and time to properly transition staff and services Been covered - they didn't. SOlid and informative post- thanks!
Wideleft Posted June 26, 2019 Report Posted June 26, 2019 7 minutes ago, nate007 said: Quick Care Clinics (at least the ones I'm aware of) had a lot of flaws that did not make them good for what I was describing. They weren't adjacent to hospitals, they had limited hours (like, worse than banks), and (at least when I went) you were encouraged to call ahead and make an appointment and were discouraged from walking in. They were very nice and modern inside though, so it wasn't surprising to see them snapped up by doctors when the leases were cancelled. The nurse practitioner model was also great, and needs to be expanded exponentially. The Quick Care concept was new and wasn't even given the chance to improve. There's nothing wrong with non-urgent problems requiring an appointment.
nate007 Posted June 26, 2019 Report Posted June 26, 2019 1 hour ago, Wideleft said: The Quick Care concept was new and wasn't even given the chance to improve. There's nothing wrong with non-urgent problems requiring an appointment. I agree, but the question was about how my proposal to put walk-in clinics next to ERs jived with the closing of Quick Care clinics. I guess what I never understood was what Quick Care clinics offered that family doctors and walk-ins don't. Nurse practitioners? Great, but why not just allow them to set up their own practices? I can't drive five minutes in Winnipeg without seeing a new doctor's office advertising that they are accepting patients.
Wideleft Posted June 26, 2019 Report Posted June 26, 2019 2 minutes ago, nate007 said: I agree, but the question was about how my proposal to put walk-in clinics next to ERs jived with the closing of Quick Care clinics. I guess what I never understood was what Quick Care clinics offered that family doctors and walk-ins don't. Nurse practitioners? Great, but why not just allow them to set up their own practices? I can't drive five minutes in Winnipeg without seeing a new doctor's office advertising that they are accepting patients. It seems like a good idea at first blush, but the hospitals being converted to Urgent Care facilities are essentially being turned into 24-hour walk-in clinics, so that would leave you with building walk-in clinics at HSC and St. B and (Grace already has one across the street, but isn't 24 hours). Not sure how much that would cost to build and staff, nor does it solve the geographical access problem for emergency care.
nate007 Posted June 26, 2019 Report Posted June 26, 2019 2 hours ago, Wideleft said: It seems like a good idea at first blush, but the hospitals being converted to Urgent Care facilities are essentially being turned into 24-hour walk-in clinics, so that would leave you with building walk-in clinics at HSC and St. B and (Grace already has one across the street, but isn't 24 hours). Not sure how much that would cost to build and staff, nor does it solve the geographical access problem for emergency care. I would just offer some sort of incentives for doctors to set up their own clinics at those locations (minimum patient volume guarantee or compensation for minimum billing shortfall). Just spitballing…
Recommended Posts